中风系列制剂治疗急性脑出血的临床与实验研究

Clinical and experimental studies of stroke on traditional Chinese medicine prescriptions(中风系列制剂) on treating acute intracerebral hemorrhage

目的 :观察羚蝎胶囊等中风系列制剂治疗急性脑出血的疗效并探索其作用机制。方法 :临床部分共收治 10 3例患者 ,随机分 3组 ,中医治疗组 5 0例 ,西医对照组 38例 ,清开灵对照组 15例。动物实验方面 ,采用胶原酶合肝素复制大鼠脑出血模型。测定大鼠脑含水量、血浆生化等指标。结果 :临床患者 3组总有效率分别为90 .0 %、76 .3%和 80 .0 % ,中医治疗组显效率显著高于西医对照组 (P<0 .0 1) ;治疗后颅内血肿吸收率依次为 :中医治疗组 >清开灵对照组 >西医对照组。动物实验显示 ,羚蝎胶囊、熄风开窍合剂、通腑合剂均能降低实验性脑出血大鼠脑含水量和神经功能缺损积分 ;羚蝎胶囊有显著降低血浆内皮素 (ET)作用 ;羚蝎胶囊和清开灵均能显著上调血浆降钙素基因相关肽 (CGRP)水平。结论 :羚蝎胶囊等中风系列制剂是治疗急性脑出血的安全有效药物 ;其作用机制可能与调节血浆 ET和 CGRP水平、减轻脑水肿和增加脑组织损伤的修复有关。

Objective:To investigate the effects of stroke on traditional Chinese medicine prescriptions(中风系列制剂),comprising antelope horn and scorpion capsule(AHSC,羚蝎胶囊),windextinguishing and apertureopening mixture(WEAOM,熄风开窍合剂) and Fu organdredging mixture(FODM,通腑合剂) on acute intracerebral hemorrhage (AICH) and its mechanism.Methods:103 patients with AICH were randomly divided into three groups,traditional Chinese medicine(TCM) therapy group ( n =50),western medicine (WM) therapy group ( n =38),Qingkailing(清开灵) therapy group ( n =15).In experiment,the rat models of AICH was created by collagenase with heparin,the brain water content and plasma biochemical index were observed.Results:The total effective rate in TCM,WM and Qingkailing groups were 90 0%,76 3% and 80 0% respectively.The significant effective rate of the TCM therapy group was higher than that of the WM therapy group ( P <0 01).The obsorbancy of intracerebral hematoma showed the following order:the TCM therapy group>the Qingkailing therapy group>WM therapy group.In experiment,brain water decreased and neurological severity scores ameliorated in AHSC,WEAOM and FODM group all and singular.The production of plasma endothelin(ET) in AHSC group was blocked.The level of plasma calcitonin generelated peptide(CGRP) in AHSC and Qingkailing groups were markedly upregulated.Conclusions:AHSC etc.stroke TCM prescriptions to treat AICH is effective and safe and the pharmaceutical mechanisms may be associated with regulating the level of plasma ET and CGRP,decreasing brain edemas and improving repair of the brain tissue.